PT - JOURNAL ARTICLE AU - Salzman, Brooke E. AU - Stonehouse, Amber AU - Studdiford, James TI - Late Diagnosis of Early Disseminated Lyme Disease: Perplexing Symptoms in a Gardener AID - 10.3122/jabfm.2008.03.070196 DP - 2008 May 01 TA - The Journal of the American Board of Family Medicine PG - 234--236 VI - 21 IP - 3 4099 - http://www.jabfm.org/content/21/3/234.short 4100 - http://www.jabfm.org/content/21/3/234.full SO - J Am Board Fam Med2008 May 01; 21 AB - The timely diagnosis of early disseminated Lyme disease presenting as multiple secondary erythema migrans lesions is sometimes delayed because this stage is infrequently encountered in a general practice. We report a case of a 60-year-old woman whose initial complaints of an erythematous, “burning” rash and flu-like symptoms led to several laboratory tests with no specific diagnosis. The correct diagnosis was only made after sorting through other possibilities in the differential diagnosis. By reproducing the medical images and reviewing the medical literature, we underscore the importance of including Lyme disease in the list of diagnoses pertaining to diffuse skin rashes in the febrile patient.